Background: Men who have sex with men (MSM) bear a high burden of syphilis infection. Expanding syphilis testing to improve timely diagnosis and treatment is critical to improve syphilis control. However, syphilis testing rates remain low among MSM, particularly in low-and middle-income countries. We describe the protocol for a randomised controlled trial (RCT) to assess whether provision of syphilis self-testing services can increase the uptake of syphilis testing among MSM in China.

RATIONALE Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences. OBJECTIVE The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma. METHODS Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma. RESULTS Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p = .08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p = .005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.

<div class="abstract" data-abstract-type="normal"><div class='sec'><span class="bold">Objective:</span><p>To describe continuity over time in reports of valuing sustainable diet practices and investigate relationships between values, household meal behaviours and dietary intake.</p></div><div class='sec'><span class="bold">Design:</span><p>Observational study. Participant ratings of how important it is for food to be produced as organic, not processed, locally grown and not GM were categorized to represent whether they valued (very/somewhat important) or did not value (a little/not at all important) each practice. Diet quality markers (e.g. fruit servings) were based on an FFQ.</p></div><div class='sec'><span class="bold">Setting:</span><p>Mailed and online surveys.</p></div><div class='sec'><span class="bold">Participants:</span><p>Young adults (<span class='italic'>n</span> 1620; 58 % female, mean age 31 (<span class='sc'>sd</span> 1·6) years) who were participating in Project EAT (Eating and Activity among Teens and Young Adults) and responded to follow-up surveys in 2003–2004 and 2015–2016.</p></div><div class='sec'><span class="bold">Results:</span><p>One-third (36·1 %) of participants reported valuing &lt;2 practices at both assessments; 11·1 and 34·5 % respectively reported valuing ≥2 practices in 2003–2004 only and in 2015–2016 only; 18·3 % reported valuing ≥2 practices at both assessments. Regression models including demographics, parental status and vegetarian status showed that valuing ≥2 practices was associated with preparation of meals with vegetables at least a few times/week, less frequent purchase of family meals from fast-food restaurants, and higher diet quality in 2015–2016. For example, those who valued ≥2 practices consumed nearly one full vegetable serving more than other young adults on an average day and part of this difference was specifically associated with intake of dark green and red/orange vegetables.</p></div><div class='sec'><span class="bold">Conclusions:</span><p>Addressing the sustainability of food choices as part of public health messaging may be relevant for many young adults.</p></div></div>

<p> <bold>Background</bold> : This study tested for differences in personal, social, and environmental correlates of moderate to vigorous physical activity (MVPA) across ethnicity/race in male and female adolescents. <bold>Methods</bold> : Self-reported MVPA and 47 potential correlates of MVPA were measured in an ethnically/racially diverse cross-sectional sample of adolescents, in Minnesota, who participated in EAT-2010 (Eating and Activity in Teens). Interactions of potential correlates with ethnicity/race on MVPA were tested in linear hierarchical regression models in boys and girls. <bold>Results</bold> : Boys reported 1.7 more weekly hours of MVPA than girls. White adolescents reported 1.1 to 2.1 more weekly hours of MVPA than nonwhite adolescents. Among girls, neighborhood road connectivity was negatively correlated with MVPA among Hispanic and Asian participants. Among boys, sports participation was positively correlated with MVPA among all ethnicities/races, except Asians. Home media equipment was positively correlated with MVPA among Hispanic boys, but negatively correlated among white boys. <bold>Conclusions</bold> : A few correlates of physical activity among adolescents differed intersectionally by ethnicity/race and sex. Sports participation and home media equipment may have differing impacts on physical activity across ethnicities and races in boys, whereas neighborhood features like road connectivity may have differing impacts on physical activity across ethnicities and races in girls. </p>

<p>Body dissatisfaction is common in adolescence and associated with negative outcomes (e.g., eating disorders). We identified common individual trajectories of body dissatisfaction from midadolescence to adulthood and predictors of divergent patterns. Participants were 1,455 individuals from four waves of Project EAT (Eating and Activity in Teens and Young Adults), a population-based, 15-year longitudinal study. Aggregate body dissatisfaction increased over 15 years, which was largely attributable to increases in weight. Growth mixture modeling identified four common patterns of body dissatisfaction, revealing nearly 95% of individuals experienced relatively stable body dissatisfaction from adolescence through adulthood. Baseline depression, self-esteem, parental communication/caring, peer dieting, and weight-based teasing predicted differing trajectories. Body dissatisfaction appears largely stable from midadolescence onward. There may be a critical period for body image development during childhood/early adolescence. Clinicians should intervene with clients experiencing body dissatisfaction before it becomes chronic and target depression, self-esteem, parent/child connectedness, and responses to teasing and peer dieting.</p>

PURPOSE This study examines how household chaos and unmanaged parental stress are associated with and contribute to variance in markers of the home food environment (family meal frequency, perceived barriers to cooking, healthful home food availability). Obtaining a better understanding of these relationships could guide more effective family-based interventions to promote healthful home food environments. METHODS The analytic sample included 819 households with children in the population-based Project EAT-IV cohort with survey data from 2015 to 2016. Multiple linear regression was used to generate means and 95% confidence intervals of home food environment variables, and estimates for the contribution of household chaos (defined by frenetic activity, loud noises and disorder), and quartiles of unmanaged parental stress (ratio of perceived stress and ability to manage stress). Model fit was also examined. RESULTS/FINDINGS Both household chaos and quartiles of unmanaged parental stress were independently and inversely associated with family meal frequency (p's < 0.001) and positively associated with perceived mealtime preparation barriers (p's < 0.001). Unmanaged parental stress was also inversely associated with healthful home food availability (p = 0.004). Models including demographic characteristics, household chaos scores, and quartiles of unmanaged parental stress index showed significantly improved model fit for all outcomes compared to less comprehensive models. Among families with high chaos, those having 7 + family meals/week were significantly more likely to have lower mealtime preparation barrier scores, younger children and higher healthful home food availability scores than families eating together less often. CONCLUSIONS Interventions to assist with parental management of stress and chaos within the home environment (e.g., establishing routines) may increase family meal frequency and the quality of children's home food environments.

Objective: To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood. Design: A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008-2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disordered eating behaviours, usual dietary intake, and weight and height. Setting: Participants were initially recruited in the Minneapolis/St. Paul metropolitan area of Minnesota, USA, in 1998-1999. Participants: The analytic sample included 2275 young adults (55 % female, 48 % non-Hispanic White, mean age 25·3 (SD 1·6) years). Results: Young adults who reported picky eating in childhood were found to currently have lower intakes of fruit, vegetables and whole grains, and more frequent intakes of snack foods, sugar-sweetened beverages and foods from fast-food restaurants. No associations were observed between picky eating in childhood and young adults' weight status, use of weight-control strategies or report of binge eating. Conclusions: While young adults who report picky eating during childhood are not at higher risk for disordered eating, those who were picky eaters tend to have less healthy dietary intake. Food preferences and dietary habits established by picky eaters during childhood may persist into adulthood.

The fit of measured variables into a social-ecological model of correlates of physical activity is rarely tested. In this study, we examined the factor structure of correlates of moderate/vigorous physical activity (MVPA) within a hypothesized social-ecological model. Methods: We measured 46 possible personal, social and environmental correlates of MVPA in 2779 adolescents participating in the Project EAT-2010 study. Confirmatory (CFA) and exploratory factor analyses (EFA) were used to determine the factor structure. Associations of factor scores with self-reported MVPA were calculated with linear regression. Results: A 6-factor CFA model did not show adequate fit. Eight factors were identified using EFA (Root Mean Square Error [RMSEA] 90% CI: 0.053 to 0.055; CFI = 0.82). A factor representing the mix of personal and social correlates showed the strongest association with MVPA. Conclusions: The 8-factor model supports independent clustering of possible environmental correlates of MVPA, but indicates that social and personal correlates may not cluster independently. The factor most strongly correlated with MVPA represented a mix of personal and social correlates. Future work will be needed to better understand how mechanisms for developing physical activity work within and across levels of the social-ecological framework.

BACKGROUND Interest in initiatives that promote home cooking has been increasing, but no studies have examined whether home cooking is associated with dietary quality using longitudinal data on meals served in a diverse sample of families. OBJECTIVE The present study examined data on multiple meals per family in diverse households to determine whether home-cooked meals are more likely to contain nutritious ingredients than pre-prepared meals. DESIGN Data for the study came from the National Institutes of Health–funded Family Matters Study. As part of this study, between 2015 and 2016, 150 families provided ecological momentary assessment data on 3,935 meals over an 8-day observation window. PARTICIPANTS/SETTING In this study, investigators followed 150 families with children aged 5 to 7 years old from six racial/ethnic groups (n=25 each non-Hispanic white, non-Hispanic black, Hispanic, Native American, Hmong, and Somali families). Recruitment occurred through primary care clinics serving low-income populations in Minnesota. MAIN OUTCOME MEASURES The main outcomes were participants’ self-reports of whether they served fruits, vegetables, and whole grains at a meal, and reports were made within hours of the meal. STATISTICAL ANALYSES PERFORMED Within-group estimator methods were used to estimate the associations between meal preparation and types of food served. These models held constant time-invariant characteristics of families and adjusted for whether the meal was breakfast, lunch, dinner, or a snack and whether it was a weekend meal. RESULTS For all racial/ethnic and poverty status groups, meals that were fully or partly home-cooked were more likely to contain fruits and vegetables than pre-prepared meals (P<0.001). Meals that were partly home-cooked were the most likely to contain whole grains (P<0.001). Restaurant meals were more likely to contain vegetables than pre-prepared meals (P<0.001) but were equally likely to contain fruits and/or whole grains as pre-prepared meals. CONCLUSIONS Interventions or initiatives that encourage fully or partly home-cooked meals may help families incorporate nutritious foods into their diets. In addition, evaluations of potential strategies to increase the likelihood of supplementing pre-prepared and restaurant meals with nutritious meal ingredients warrants further investigation.

OBJECTIVE Prospective associations between obesity in adolescence and adult socioeconomic outcomes, and potential mediators, were examined in a contemporary cohort. METHODS Longitudinal data collected in 1998 to 1999 (Project EAT-I) and 2015 to 2016 (EAT-IV) were analyzed for 1,796 participants who provided data at both time points. Adolescents (mean age = 14.8 years) self-reported demographic and psychosocial variables (EAT-I) and follow-up outcomes (EAT-IV). Body weight and height were directly measured. Bachelor's degree or more education, income ≥ US $50,000, and partnered status at follow-up were examined by baseline obesity (>95th BMI percentile) using logistic regression. Self-esteem, depression, and weight-related teasing were examined as mediators using multivariate probit regressions. All analyses were adjusted for race, baseline age, and parent socioeconomic status. RESULTS Girls with obesity were significantly less likely to have achieved a bachelor's degree (OR 0.32, 95% CI [0.18, 0.58]; P < 0.001), earn ≥ $50,000 annually (OR 0.57, 95% CI [0.33, 0.99]; P < 0.04), or be partnered (OR 0.45, 95% CI [0.27, 0.75]; P < 0.002) in adulthood. No associations were observed among boys. Among girls, depression mediated 8.5% and 23.6% of the association between adolescent obesity and adult education and income, respectively. CONCLUSIONS Adolescent girls with obesity have lower educational attainment and income and are less likely to be partnered in later adulthood. Depression may partly mediate the associations.

INTRODUCTION Determining the population-based scope and stability of eating, activity, and weight-related problems is critical to inform interventions. This study examines: (1) the prevalence of eating, activity, and weight-related problems likely to influence health; and (2) the trajectories for having at least one of these problems during the transition from adolescence to adulthood. METHODS Project EAT I-IV (Eating and Activity in Teens and Young Adults) collected longitudinal survey data from 858 females and 597 males at four waves, approximately every 5 years, from 1998 to 2016, during the transition from adolescence to adulthood. Analyses were conducted in 2017-2018. Measures included high fast-food intake (≥3 times/week), low physical activity (<150 minutes/week), unhealthy weight control, body dissatisfaction, and obesity status. RESULTS Among females, the prevalence of having at least one eating, activity, or weight-related problems was 78.1% at Wave 1 (adolescence) and 82.3% at Wave 4 (adulthood); in males, the prevalence was 60.1% at Wave 1 and 69.2% at Wave 4. Of all outcomes assessed, unhealthy weight control behaviors had the highest prevalence in both genders. The stability of having at least one problem was high; 60.2% of females and 34.1% of males had at least one problematic outcome at all four waves. CONCLUSIONS The majority of young people have some type of eating, activity, or weight-related problem at all stages from adolescence to adulthood. Findings indicate a need for wide-reaching interventions that address a broad spectrum of eating, activity, and weight-related problems prior to and throughout this developmental period.

Introduction: To determine the prevalence of reaching multiple Healthy People 2020 (HP 2020) objectives including nutrition and weight status, sleep health, physical activity, health-related quality of life, social determinants of health, and education among low-income, diverse children and adults. Methods: Children ages 5- to7-yearsold (n = 150; 47% female) and their parents (mean age = 35; 91% mothers) from 6 racial/ethnic and immigrant/refugee groups (n = 25 from each; African American, Native American, Hispanic, Hmong, Somali, White) participated in this cross-sectional mixed-methods study. Results: Overall, the majority of HP 2020 objectives were not being met across this low-income, racially/ethnically diverse, and immigrant/refugee sample of children and adults. In particular, African American children and parents consistently fell below the majority of the HP 2020 targets, with only 5 of the 24 HP 2020 objectives being met. Additionally, immigrant children and parents met less than 2/3 of the HP 2020 objectives. Discussion: Concerted public health efforts are needed to address the disparities in reaching the HP 2020 objectives and informing the development of the future HP 2030 objectives among low-income, racially/ethnically diverse, and immigrant children and parents. In order to achieve and assess the current and future HP objectives in these diverse populations, changes may be needed in both interventions and assessment tools.

Background: Although prior research suggests that stress may play a role in parent's use of food-related parenting practices, it is unclear whether certain types of stress (e.g., transient, chronic) result in different food-related parenting practices. Identifying whether and how transient (i.e., momentary; parent/child conflict) and chronic (i.e., long-term; unemployment >6months) sources of stress are related to parent food-related parenting practices is important with regard to childhood obesity. This is particularly important within racially/ethnically diverse parents who may be more likely to experience both types of stress and whohave higher levels of obesity and related health problems. The current study examined the association between transient and chronic stressors and food-related parenting practices in a racially/ethnically diverse and immigrant sample. Methods: The current study is a cross-sectional, mixed-methods study using ecological momentary assessment (EMA). Parents (mean age=35; 95% mothers) of children ages 5-7years old (n=61) from six racial/ethnic groups (African American, American Indian, Hispanic, Hmong, Somali, White) participated in this ten-day in-home observation with families. Results: Transient stressors, specifically interpersonal conflicts, had significant within-day effects on engaging in more unhealthful food-related parenting practices the same evening with across-day effects weakening by day three. In contrast, financial transient stressors had stronger across-day effects. Chronic stressors, including stressful life events were not consistently associated with more unhealthful food-related parenting practices. Conclusions: Transient sources of stress were significantly associated with food-related parenting practices in racially/ethnically diverse and immigrant households. Chronic stressors were not consistently associated with food-related parenting practices. Future research and interventions may want to assess for transient sources of stress in parents and target these momentary factors in order to promote healthful food-related parenting practices.